Why I don’t recommend e-cigarettes for teens

E-cigarette use in teens has doubled in a year. The CDC reports that 1 in 10 high school students admitted to ever using an e-cigarette in 2012. The rate of use doubled for middle school students as well. Although I’m not surprised, I remember just weeks ago tweeting about my dismay with Jenny McCarthy’s new job — advertising e-cigarettes. I took flak. Some advocates for e-cigs felt I was shortsighted and not valuing the potential benefits of these electronic nicotine-laden vapor tubes. All I could think of was her image, the lure she may create for teens, and the likelihood that teens would peek in on e-cigs with greater fervor.

Just a month ago we learned that smokeless tobacco use is steady with teens (5%) and many teens are now turning to novel sources of nicotine (dissolvable tobacco, snuff, snus) in addition to tobacco cigarettes. I consider myself fairly up to date, and until the AAP report came out in August I’d never once heard of snus. You?

Some people are wed to the concept that e-cigs may reduce the burden of illness and smoking-related morbidity from tobacco cigarettes. Even if you believe in harm-reduction for adults (switching from tobacco cigarettes to e-cigs to reduce use or quit) this is an entirely different issue for our middle and high-school students. A nice summary of the data for e-cigs from pediatrician, Aaron E. Carroll, with numerous associated comments helps frame the issue.

I wish I could remain agnostic about these devices, but I can’t. This is pretty easy to say: I don’t recommend e-cigarettes for a teen.

Why I don’t recommend e-cigarettes for teens 2 comments

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May Wright

From your CDC link:

“In 2012, among high school ever e-cigarette users, 7.2% reported never
smoking conventional cigarettes; among high school current e-cigarette
users, 80.5% reported current conventional cigarette smoking.”

So 80.5% of these high school e-cig users are already tobacco smokers.

Only a small number of e-cig users (7.2%) have never smoked tobacco cigarettes. So it’s conceivable that, rather than e-cigs being the “gateway drug” to tobacco cigs, it could be the reverse.

I agree that children absolutely should not be using any kind of product containing nicotine. And supplying e-cigs to children should be just as illegal as supplying tobacco cigs to them. But given that we’re already not very good at keeping motivated children from getting their hands on the already highly restricted tobacco cigarettes, I think it’s a little optimistic to think that federal legislation alone will work any better to keep e-cigs away from them than it does tobacco cigs.

And at worst, I worry that overly heavy regulation and taxation of e-cigs will make them too hard to get and too expensive for exactly that cohort which could really benefit from switching to them, lower income adults who currently smoke tobacco cigarettes.